Provider Demographics
NPI:1265435424
Name:HATFIELD, DAVID BONNELL (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BONNELL
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 ELKTON DR
Mailing Address - Street 2:STE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8507
Mailing Address - Country:US
Mailing Address - Phone:719-640-8066
Mailing Address - Fax:
Practice Address - Street 1:1115 ELKTON DR
Practice Address - Street 2:SUITE 403
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8507
Practice Address - Country:US
Practice Address - Phone:719-574-6562
Practice Address - Fax:719-570-0386
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2559103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2559OtherPSYCHOLOGIST LICENSE